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2 型糖尿病患者心脏自主神经病变与冠状动脉病变的关系。

Association between Cardiac Autonomic Neuropathy and Coronary Artery Lesions in Patients with Type 2 Diabetes.

机构信息

Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Dis Markers. 2020 Dec 30;2020:6659166. doi: 10.1155/2020/6659166. eCollection 2020.

Abstract

OBJECTIVE

Cardiac autonomic neuropathy (CAN) is a common and serious complication of diabetes mellitus with various systemic involvements, such as atherosclerotic cardiovascular disease. We aimed to evaluate the association between CAN and coronary artery lesions in patients with type 2 diabetes. . We retrospectively reviewed the medical records of 104 patients with type 2 diabetes and coronary artery disease (CAD). We evaluated heart rate variability (HRV) parameters (SDANN, SDNN, and pNN50) to assess cardiac autonomic function. The severity of coronary lesions was assessed by the Gensini scores and the number of affected vessels. Correlation analyses between HRV parameters and the severity of coronary lesions and clinical parameters were performed.

RESULTS

Spearman's correlation analysis showed a significant negative correlation between SDANN and Gensini scores ( = -0.22, = 0.03). Interestingly, this finding remained significant after adjusting for clinical covariates ( = -0.23, = 0.03). However, there was no association between HRV parameters and the severity of coronary lesions as assessed by the number of affected vessels. Clinical parameters were not significantly correlated with HRV parameters (all > 0.05).

CONCLUSIONS

Cardiac autonomic neuropathy might be related to the degree of coronary atheromatous burden in patients with type 2 diabetes. Screening for cardiac autonomic neuropathy might potentially be beneficial in the risk stratification of patients with type 2 diabetes.

摘要

目的

心脏自主神经病变(CAN)是糖尿病的一种常见且严重的并发症,涉及多种系统,如动脉粥样硬化性心血管疾病。我们旨在评估 2 型糖尿病患者中 CAN 与冠状动脉病变之间的关系。

方法

我们回顾性分析了 104 例 2 型糖尿病合并冠心病(CAD)患者的病历。我们评估了心率变异性(HRV)参数(SDANN、SDNN 和 pNN50)来评估心脏自主功能。冠状动脉病变的严重程度通过 Gensini 评分和受累血管数来评估。对 HRV 参数与冠状动脉病变严重程度和临床参数之间的相关性进行了 Spearman 相关分析。

结果

Spearman 相关分析显示,SDANN 与 Gensini 评分呈显著负相关( = -0.22, = 0.03)。有趣的是,在调整临床协变量后,这一发现仍然显著( = -0.23, = 0.03)。然而,HRV 参数与受累血管数评估的冠状动脉病变严重程度之间没有关联。临床参数与 HRV 参数无显著相关性(均>0.05)。

结论

心脏自主神经病变可能与 2 型糖尿病患者冠状动脉粥样硬化负担的程度有关。筛查心脏自主神经病变可能有助于 2 型糖尿病患者的风险分层。

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